Female Reproductive System Flashcards
What is the female internal genital organs?
- Ovaries
- Uterine tubes
- Uterus
- Vagina
It is a child baring organ it is muscular organ, having outer perimetrium, myometrium, and inner endometrium
Uterus
Where the embryo in the morula stage gets implanted?
It gets implanted in the endometrium of the uterus and grows further in the uterus
Where is the uterus located?
Located in the lesser pelvis between urinary bladder anteriorly and rectum posteriorly
What covers the uterus?
It is covered by the peritoneum
What are the parts of the uterus?
- Fundus
- Body
- Cervix
What is the normal position of the uterus?
The normal position of the uterus in the pelvic cavity is described as
Anteverted and anteflexed
When we say the uterus is abnormal?
Uterus is may be retroverted and retroflexed (abnormal)
It is the forward angular ion of uterus between the long axis of the cervix and vagina and it is 90 *
Angle of the anteversion
What is the angle of anteversion?
Forward angular ion of uterus between the long axis of cervix and vagina
What is the degree of angular ion of angle of anteversion?
It is about 90 degree
It is the forward angulation between the body and cervix of the uterus
It is about 125 degree
Angle of anteflexion
Any backward tilt in the angle of anteversion
Retroveretdd uterus
What is the effect of retroverted uterus?
Has tendency for prolapse
Painful menstruation
Reduced the chance of of conception
What covers the the uterus?
It is covered by peritoneum,
forms recto-uterine
Vesicouterine pouches of peritoneal cavity
What structures are found in the lower anterior surface of the uterus?
Flat and faces downwards and forwards
It is covered by peritoneum up to the isthmus
Related to urinary bladder
How the uterus is separated from the urinary bladder?
It is separated from the urinary bladder by uterus-vesicle peritoneal pouch
What is found in the upper (posterior) surface?
Convex and directed upwards and backward
Related to the rectum and sigmoid colon
Up to where the upper (posterior) surface of the uterus covered by the peritoneum?
It is covered by peritoneum up to the posterior fornicate of the vagina
How is the uterus separated from the rectum?
By recto-uterine peritoneal pouch (pouch of Douglas)
What does the rect-uterine peritoneal pouch (pouch of Douglas) is occupied with?
Is occupied by coils of intestine and sigmoid colon
What is the other name for recto-uterine peritoneal pouch?
Pouch of Douglas
What is found in the lateral border of the uterus?
The lateral border of the uterus contains :
Provides attachment to the broad ligament of the uterus
Provides attachment —> round ligament of uterus and ovarian ligament at is upper end
Where the uterine tube opens?
Uterine tube opens to the uterus at the superior-lateral angle
What is the uterine artery located?
Ascends between the two layers of broad ligament along the lateral border
Most fixed part of the uterus (not moveable and not distending during pregnancy)
Cervix of the uterus
What are parts of the cervix of the uterus?
- Vaginal and supravaginal parts
- Internal ostium
- Cervical canal
- External ostium
What is located lateral to the uterine of the cervix?
Uterine artery crossing the ureter
What lines the cervical canal?
Simple columnar
Or
Stratified squamous epithelium
Does the endometrium show periodic changes?
Endometrium does not show periodic changes during menstrual cycle, like in the fundus and body of the uterus
What are the ligaments of the cervix?
- Mackenrodt’s ligament
- Uterosacral ligament
- Pubocervical ligaments
Are attached to it and provide support to the uterus
What is the blood supply of the uterus?
- Ovarian artery
2. Uterine artery
What is the ovarian artery branch of ?
How it enters?
It is a branch of abdominal aorta
Entering through suspenders ligament of the ovary
From where the uterine artery?
It is a branch of internal iliac artery
What supports the uterus?
- Pelvic diaphragm
- Perineal body
- The external urethral sphincter
- Condensation of the pelvic fascia
Pubocervical ligament
Transverse cervical ligament
Uterosacral ligament - Axis of the uterus
- Round ligament of uterus
Which muscle makes the pelvic diaphragm?
Pubovaginalis part of the lavatory ani forms a sling around the vagina acting as a sphincter
When pubovaginalis muscle could be injured and what happens if it was injured?
During vaginal delivery
Damage to pelvic diaphragm or perineal body during vaginal delivery can cause perineal body during vaginal delivery can cause prolapse of uterus during later part of the life
It can also lead to urinary incontinence as it disturbs the position of the neck of the bladder, which is characterized by dribbling of urine when intra abdominal pressure is raised during coughing and lighting
What is the perineal body?
It is a fibromuscular node which acts as an anchor and maintains the integrity of the pelvic floor
From where the perineal body receives attachment?
It recieves attachment of many perineal muscles and also pubovaginalis part of levator ani muscle
What does perineal body injury leads to?
If the perineal body is torn during vaginal delivery or during episiotomy and not properly repaired, this can cause prolapse if the uterus
It extends from anterior aspect of the cervix to posterior surface of pubic symphysis
Pubocervical ligament
This is also called cardinal ligament or meckenrodts ligament
Transverse cervical ligament
Extends from the lateral aspect of the cervix to the lateral pelvic wall
Transverse cervical ligament
Where does transverse cervical ligament pass through?
It passes through the base of the broad ligament
How the uterine arteries reach the uterus?
Through the transverse cervical ligament
It a ligament that extends from the posterior aspect of the cervix to 3rd pice of the sacrum
Uterosacral ligament
It is a ligament that pulls the cervix backward and helps to maintain the normal axis of the uterus
Uterosacral ligament
What is the importance of the axis of the uterus?
It is an important mechanical factor stabilizing the uterus
Is a ligament that tends to pull the fundus forward
Round ligament
It is a ligament that tend to pull the cervix backward?
Uterosacral ligament
What is the importance of the ligaments?
These ligaments maintain the normal axis of the uterus
Double layered peritoneal fold extends from the lateral border of the uterus to the lateral pelvic wall
Broad ligament of the uterus
Medial border of the broad ligament is attached to what?
It is attached to the lateral border of the uterus
Lateral border of the broad ligament is attached to what?
It is attached to the lateral pelvic wall
What does the upper border of the broad ligament encloses?
In its medial 3/4 —> it is free, encloses the uterine tube in its medial 3/4
In its lateral 1/4 —> form suspenseful ligament of the ovary for the passage of ovarian vessel s
What does the upper 1/4 lateral of the broad ligament forms?
It forms the suspensory ligament of the ovary
What passes in the suspensory ligament of the ovary?
Ovarian vessels
To what the lower border of the broad ligament is attached?
Is attached to pelvic floor where the two layers move apart
To what is the lower boarder of the broad ligament is related?
It is related to transverse cervical ligament and uterine vessels
The posterior layer of the broad ligaments extends towards ovary as a double layered fold called_——-
Mesovarium
It is a portion between the uterine tube and attachment of mesovarium
Mesosalpinx
Part of the broad ligament bellow the attachment of the mesovarium
Mesometrium
What are the contents of the broad ligament of the uterus?
Uterine tube Uterine vessels Ovarian vessels Round ligament of uterus Ligament of the ovary Lymphatics and nerve fibers
Proximal mesonephric tubules?
Epophoron
Regents of the mesnephric duct?
Duct of epoophoron (Gardner’s duct)
Remnants of distal mesonephric tubules?
Paroophoron
Is a surgical procedure of removal of the uterus
Hysterectomy
What is the reason for performing hysterectomy?
It is very common operation, performed most often to treat tumors and cancers of the uterus
What are sites where the ureter is at risk during surgery?
- While lighting the ovarian vessels within the suspensory ligament of the ovary ( ureter just lies medial to these vessels
- While lighting the uterine artery —> ureter crosses the uterine artery inferiorly
- The ureters are at risk in a vagina hysterectomy as they course just laterally to the uterine cervix
Are female gonads
Ovaries
What are the functions of the ovaries?
It acts as an endocrine gland also
Where is the ovary located ?
Located/ attached to posterior aspect of the broad ligament by mesovarium (double fold of peritoneum)
What attaches the ovary to the posterior part of the broad ligament?
Mesovarium (double fold of peritoneum)
Where is the ovary situated?
The ovary is situated in the ovarian fossa on the lateral pelvic wall
The ovarian fossa is bounded anteriorly by?
Obliterated umbilical artery
The ovarian fossa is bounded posteriorly to?
Ureter and internal iliac artery
The ovarian fossa is bounded laterally by?
Obturator internus muscle
Are normal ovaries palpable?
Though normal ovaries are not palpable—> enlarged ovaries and ovaries in recto-uterine pouch are palpable by vaginal examination
What is located in the upper end of the ovary?
Uterine tube
With what is the lower end of the ovary connected?
The lower end of the ovary (uterine end) is connected with super-lateral angle of the uterus by the ligament of ovary
With what the anterior border of the ovary connected?
The anterior border of the ovary is connected to the posterior layer of broad ligament by peritoneal fold called mesovarium
What enters the ovary through the mesovarium?
The ovarian vessels and nerves enter the ovary through it
What we also called the mesovarium?
This is also referred as white line of the ovary and hilum of the ovary
What is the consequences of having long mesovarium or suspensory ligament of the ovary?
Can cause torsion of the ovary
What is the consequences of ovarian torsion?
Ovarian torsion compresses the blood vessels and cause severe abdominal pain
What is related to the posterior boarder of the ovary?
Free and related to internal iliac vessels and ureter
What is located in medial side of ovary?
Uterine tube
What is located in the lateral surface of the ovary?
Ovarian fossa
To what is the ovarian fossa related to and what is the significance of that?
The ovarian fossa is related to the obturator nerve and this explains why pain is felt in the obturator region of the thigh in diseases of the ovary
What supplies the ovary and what is its origin?
The ovary is supplied by ovarian artery
It is a branch of abdominal aorta
What is the path of the ovarian artery?
The ovarian artery enters the suspensory ligament of the ovary
Then broad ligament and finally reach ovary through mesovarium
What also the ovarian artery supplies?
The ovarian artery supplies the uterine tube and uterus
With what the ovarian artery anastomoses?
The ovarian artery anastomoses with the uterine artery
Describe the venous drainage of the ovary?
Ovarian vein —> follow ovarian artery and drains into inferior vena cava on the right side, and left renal vein on the left side
Where the lymph nodes of the ovary drain?
The lymph vessels accompany the blood vessels and drain into the pre and para aortic lymph nodes
What is the nerve supply of the ovary?
The sympathetic fibers are derived from T10 to T12 segment of the spinal cord, which carry pain sensation from the ovary.
Hence ovarian pain is felt at the pubic and lower abdominal region
It is a muscular tube conveys sperms to the ampullary part and conveys early embryo to the uterus
Fallopian tube
What is another name for Fallopian tube?
Uterine tube
What are parts of the Fallopian tube?
- Infundibulum
- Ampulla
- Isthmus
- Intramural part
What supplies the uterine tube?
The uterine tube is supplied by branches of the uterine and ovarian arteries
What part of the uterine tube I supplied by the uterine artery?
Uterian artery supplies the medial 2/3
What part of the uterian artery is supplied by ovarian artery?
Ovarian artery at the lateral 1/3 rd
What is the venous drainage of the uterine tube?
Venous blood is drained into uterine and ovarian veins
What is the innervation of the uterine tube?
The sympathetic is derived from T10 to L2 segment of the spinal cord
The parasympathetic fibers are derived from both vagus and pelvic splanchnic nerves
It is a radiological technique to check the patency of the uterian tube?
Hysterosalphyngiogrsphy
What is injected into the uterian cavity during hystersalphyngiography?
Radio-opaque material is injected into uterine cavity
Is a pregnancy that results when blastocyst implants in locations other than the lumen of the uterus?
Tubal pregnancy (ectopic pregnancy)
What are sites for ectopic pregnancies?
Uterine tube (95% to 97%)
Ampulla (normal site for fertilization)
Isthmus ( the narrowest portion of the Fallopian tube)
What is the normal site for fertilization?
Ampulla of the uterian tube
What is the narrowest portion of the Fallopian tube?
Isthmus of the Fallopian tube
What cause ectopic pregnancy?
Any condition that might prevent or delay in transport of zygote to the uterus may cause an ectopic tubal pregancy
When tubal ectopic pregnancy will usually rupture?
Tubal ectopic pregnancy will usually rupture during the first 8 weeks of pregnancy
What does rupture of tubal pregnancy usually result in?
Tubal ectopic pregnancy rupture will typically result in abortion and intra-abdominal bleeding, with resultant hypotension and tachycardia
In which position the tubal pregnancy ruptures the soonest?
Tubal pregnancy in the narrow isthmus tends to rupture sooner than those in the ampulla and produce greater hemorrhage than implantation in the ampulla
What could happen to blastocysts implanted in the ampulla?
Blastocyst implanted in the ampulla may be expelled into the abdominal cavity, where they may re-implant
What does ruptured uterine tube requires?
Ruptured uterine tube requires immediate surgical interference, because it can be a threat to mother’s life
It is a surgical procedure for female sterilization for birth control
Tubectomy
How is tubal ligation done?
Abdominal tubal ligation
Laparoscopic method —> cauterization/ clipping
Is a fibromuscular canal forming the female copulatory organ.
Vagina
From where to where the vagina extends ?
The vagina extends from the vulva (external genital organ) to the uterus
What is the difference between the vagina anterior wall and the vagina posterior wall?
The vagina anterior wall is short than the vagina posterior wall
The lower end of the vagina is partially closed by a thin annular fold of mucous membrane called the ______________ until first menstraul flow
What is the blood supply of the vagina?
The vagina is supplied by the vaginal artery which is a branch of internal iliac artery
In addition the upper part of the vagina recieves blood from the uterian artery
The vagina artery is a branch of which artery?
The vaginal artery is a branch of the internal iliac artery
What is the venous drainage of the vaginal artery?
The veins drain into the internal iliac vein
What is the lymphatic drainage of the vagaina?
Upper part drains into —> external iliac group of nodes
Middle part into —> internal iliac nodes
Inferior part —> sacral and common iliac nodes
From the external orifice —> into the superficial inguinal lymph node
What lines the mucosa of the vagina?
The mucosa of the vagina is lined by stratified squamous non-keratinized epithelium
Does the vaginal mucosa have any glands and how it get moistures?
The vaginal mucosa doesn’t have any glands
It is kept moist by
cervical glands in the —> upper part
Lesser vestibular glands —> in the lower part
What is located anteriorly to the vagina?
Base of the bladder in the upper part and urethra in the lower part
Posteriorly what is related to the vagina?
In the upper part —> it is separated from rectum by rectouterian pouch
In the middle part —> it is separated from the rectum by loose connective tissue
In the lower part —> it is separated from the anal canal by the perineal body
What is related to the vagina laterally?
It is surrounded by pubococcygeus part of the levator ani muscle (pelvic diaphragm)
Above the pelvic diaphragm it is related to transverse cervical ligament with uterine artery
In the lower part the lateral wall is related to bulb of the vestibule which is covered by bulbospongious muscle
What are the nerves that supply the vagina?
The lower part of the vagina is supplied by —> pudendal nerve and is Sensitive to pain
The upper part of the vagina is supplied by what?
Autonomic fibers derived from the inferior hypogastric nerves
The sympathetic fibers of the vagina arise from which segments?
Sympathetic is derived from L1/2 segment of the spinal cord
Parasympathetic is from s2/s3/s4 pelvic splanchnic nerve
Over distention of the upper part of the vagina causes pain
What are types of pervaginal examination?
Is helpful in palpating many pelvic organs like rectum, ovary, uterian tubes
The diagonal conjugate of the pelvis can also be assessed
Normally the finger fails to reach the sacral promontory
If promontory is palpable the pelvis is narrow
Prolapse of the anterior wall of the vagina causes —> cystocele and urethrocele
The prolapse of the posterior wall causes recto cell
Is a cell/ tissue study from the cervical endometrium
Pap-smear
What is the procedure of the Pap smear?
A speculum is placed in the external os of the uterus
The spatula is rotated to scrape cellular material from the mucosa of the vaginal part of the cervix
The Cytob rush is inserted into the cervical canal and rotated to collect the mucosa from the supravaginal part of the cervix
The cellular material is placed on glass slide and a smear is prepared for cytological studies
Is a space between the labia minors into which the orifice of the urethra/ vagina and ducts of greater lesser vestibular glands open
Vestibule of vagina
Where is the external urethral orifice located?
It is located anterior to the vaginal orifice
Where the ducts of the paraurethral gland open?
The ducts of the paraurethral gland open on each side of the urethral orifice
Where the lesser vestibule glands open?
Opens into the vestibule between urethral and vagina orifice
What are the bulb of the vestibule?
They are pair of erectile tissue approximately 3 cm in length
They are located at the side of the vaginal orifice
It is firmly attached to the perineal membrane
They are covered by bulbospongiosus muscle
What are the vaginal vestibules?
Vesicovaginal fistula
Rectovaginal fistula
Urethrovaginal fistula
Vaginoperineal fistula
